<div class="row-content am-cf">
    <div class="row">
        <div class="am-u-sm-12 am-u-md-12 am-u-lg-12">
            <div class="widget am-cf">
                <form id="my-form" class="am-form tpl-form-line-form" method="post">
                    <div class="widget-body">
                        <fieldset>
                            <div class="widget-head am-cf">
                                <div class="widget-title am-fl">代理申请</div>
                            </div>
                            <div class="am-form-group">
                                <label class="am-u-sm-3 am-u-lg-2 am-form-label form-require">代理级别 </label>
                                <div class="am-u-sm-9 am-u-end">
                                    <label class="am-radio-inline">
                                        <input type="radio" name="data[agent_mode]" value="10" data-am-ucheck checked>
                                        区县
                                    </label>
                                    <label class="am-radio-inline">
                                        <input type="radio" name="data[agent_mode]" value="20" data-am-ucheck>
                                        市级
                                    </label>
                                    <label class="am-radio-inline">
                                        <input type="radio" name="data[agent_mode]" value="30" data-am-ucheck>
                                        省级
                                    </label>
                                </div>
                            </div>
                            <div class="am-form-group am-padding-top">
                                <label class="am-u-sm-3 am-u-lg-2 am-form-label form-require"> 联系人 </label>
                                <div class="am-u-sm-9 am-u-end">
                                    <input type="text" class="tpl-form-input" name="data[details][id_card_name]"
                                           placeholder="请输入联系人" required>
                                </div>
                            </div>
                            <div class="am-form-group">
                                <label class="am-u-sm-3 am-u-lg-2 am-form-label form-require"> 联系电话 </label>
                                <div class="am-u-sm-9 am-u-end">
                                    <input type="text" class="tpl-form-input" name="data[details][mobile_phone]"
                                           placeholder="请输入联系电话" required>
                                </div>
                            </div>
                            <div class="am-form-group">
                                <label class="am-u-sm-3 am-u-lg-2 am-form-label form-require"> 区域坐标 </label>
                                <div class="am-u-sm-9 am-u-end">
                                    <div class="am-block">
                                        <input type="text" style="background: none !important;" id="coordinate"
                                               class="tpl-form-input" name="data[location]"
                                               placeholder="请选择区域位置" readonly="" required>
                                    </div>
                                    <div class="am-block am-padding-top-xs">
                                        <iframe id="map" src="/user/apply/getpoint" width="915" height="610"></iframe>
                                    </div>
                                </div>
                            </div>
                            <div class="am-form-group">
                                <div class="am-u-sm-9 am-u-sm-push-3 am-margin-top-lg">
                                    <button type="submit" class="j-submit am-btn am-btn-secondary">提交
                                    </button>
                                </div>
                            </div>
                        </fieldset>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>
<script>
    /**
     * 设置坐标
     */
    function setCoordinate(value) {
        var $coordinate = $('#coordinate');
        $coordinate.val(value);
        // 触发验证
        $coordinate.trigger('change');
    }
	
    $(function () {
		
        $('#my-form').formPost();

    });
</script>
